Baseball Injuries

Baseball is considered one of the most beloved sports and has millions of participants on the professional, collegian, and junior levels and in recreational and organized league settings. While baseball is classified as a non-contact sport, play isn’t without risk of injury. Considering that baseball is a non-contact sport, the injury statistics can be somewhat surprising.

The U.S. Consumer Products Safety Commission estimates that there are over 627,000 baseball-related injuries treated each year in U.S. emergency rooms. Studies performed by the American Academy of Pediatrics and the National SAFE KIDS Campaign estimate that almost 117,000 kids between the ages of five to 14 are treated in U.S. emergency rooms for baseball injuries each year, over 24,000 of which required overnight hospitalization. Of course, these are just the injuries treated by emergency room departments and doesn’t even begin to account for the countless injuries that are treated at home or in outpatient medical clinics.

How Do Baseball Injures Occur?

Baseball is a sport that involves sliding from a fast run, throwing high-speed balls with great force and for long distances, receiving balls that are traveling at high-speeds, jumping in the air to catch balls, forcefully swinging a bat, and so forth. Baseball injuries can broadly be categorized as either cumulative overuse/repetitive use injuries or traumatic injuries.

Overuse injuries are the result of repetitively subjecting the muscles, tendons, ligaments, joints, and so forth to stress, such as from playing too long, too hard, or too often. Overuse injuries are commonplace in the shoulders, elbows, and wrists of baseball players, especially pitching positions, due to the frequency, force, and distance involved in throwing high-speed balls. In fact, organized teams usually have several pitchers that rotate throughout the game due to the stress throwing a ball overhead at such a high-speed and from such an unnatural position causes to a pitcher‘s body.

Traumatic injuries, which are caused by a direct force or impact, frequently occur as the result of a player coming into contact with another player, a ball, or a bat. For example, a player may slide and collide with a baseman or the catcher or fall while diving for a ball in the outfield.

What Are Some Common Baseball Injuries?

Medial Epicondylitis

This injury is also commonly referred to as pitcher’s elbow, thrower’s elbow, or golfer’s elbow due the high occurrence in throwing sports and golf. In children, the same condition may be referred to as Little League elbow. In any event, medial epicondylitis is similar to tennis elbow, but it occurs on the inside (medial) aspect of the elbow instead of the outside aspect. The pain is usually most extensive along the inside bump of the elbow, called the medial epicondyle, and may limit the elbow and wrist's range of motion.

The wrist flexor muscles that are located on the palm side of the forearm are responsible for actions such as wrist flexion, turning the forearm downwardly, and hand-grip. The majority of these muscles are attached to a common tendon, called the common flexor tendon, on the medial epicondyle. When excessive or repetitive force is used to accomplish the above actions, the common flexor tendon may become inflamed (tendinitis) or suffer degenerative changes on a cellular cell (tendonosis) where it attaches to the medial epicondyle.

Separated Shoulder

Shoulder dislocations and shoulder separations are often confused, but they actually involve two different joints.

The AC joint is located on the distal end of the clavicle. It functions as an attachment point between the acromion process atop the shoulder blade and the scapula. Shoulder separations are technically sprains to the the acromioclavicular and/or coracoclavicular ligaments that hold the acromioclavicular (AC) joint in place. A separated shoulder may involve the following types of sprains:

* The acromioclavicular ligament may be abnormally stretched or suffer microscopic tearing, which is a grade one sprain; suffer a partial tear, which is a grade two sprain; or suffer a complete rupture, which is a grade three sprain.

* A grade three acromioclavicular ligament sprain may accompany a grade one or two sprain of the coracoclavicular ligaments, which results in the shoulder bones slightly separating and creating a bump on the top of the shoulder.

* The coracoclavicular ligament may rupture and be pulled away from its attachment to the clavicle. This is called an avulsion injury and results in obvious displacement of the clavicle bone.

Rotator Cuff Injuries

The rotator cuff is made up the supraspinatus, infraspinatus, subscapularis, and teres minor muscles and their tendons. This cuff helps to stabilize and fluidly move the shoulder. The most common mechanism of injury is from repetitive overhead motions, such as throwing a baseball, but it can be injured if the shoulder suffers a direct blow.

Injuries to the rotator cuff usually involve either the irritation and inflammation of a rotator cuff tendon (tendinitis) or one of the rotator cuff muscles and/or tendons being abnormally stretched or rotator cuff tear (strain). Of note, chronic tendinitis often leads to strains.

Like all strains, rotator cuff strains are graded based on the degree of stretching or tearing to the musculotendinous unit:

Grade I - the rotator cuff may suffer mild stretching to microscopic tearing of the musculotendinous fibers, but the shoulder joint remains mobile and stable. This injury may or may not be accompanied by mild localized shoulder swelling and pain.

Grade II - moderate tearing of the musculotendinous fibers in the rotator cuff that produces some joint instability and range of motion limitations. The injury may be accompanied by moderate localized swelling, pain, heat, and bruising.

Grade III - extensive to complete tearing of the musculotendinous fibers that involves significant to complete joint instability and immobility.